Sadly, it is fairly common for survivors of sexual abuse (and
other types of power abuse) to indulge in self-destructive behaviors such as
cutting. Cutting is willful injury to one's self using something sharp.
Obviously, the motivations for cutting can lead to other forms of
self-mutilation besides actual bloodletting. The key point is that all of them
hurt, and all of them cause some sort of damage to one's body. The phenomenon
has become known in general as "cutting" because more people seem to
have specifically cut themselves than hurt themselves in other ways. This is not
to invalidate anyone else's experiences, it's just that "cutting" has
become a convenient label. (1)

Episodic self-injurious behaviour (SIB) is observed among
normally developing children and teenagers. Chronic and severe SIB is more
common among people with developmental or psychiatric disabilities or other
special populations such as prisoners. SIB may be related to specific biological
conditions or syndromes. SIB can be used for attention-seeking,
self-stimulation, or for communication (to either get or avoid something).
Effective intervention programmes identify and remedy the cause, and teach
replacement behaviours. (www.uq.edu.au)

There are several theories as to why people indulge in
self-mutilation. One is that it's a control issue. When children are abused,
they are in a situation of no control. Their abuser(s) can hurt them any time,
and the children are largely (if not completely) powerless to stop it. When the
child grows older and is faced with stressful situations, there is often a
strong desire/expectation for some sort of pain, since pain is associated with
stress in that person's mind. People who have had these associations forced on
them frequently cut themselves because this is a pain that satisfies the
psychological desire for pain, and is *also* a pain that the victim can stop. At
last the person is in control. And while the cutting itself is harmful and can
cause shame and guilt later, I can tell you that the control feels good.

Another theory is that people who were abused as children
often have been taught (by their abusers, or by others who have denied the
child's experiences as being valid) that they are bad people, who should by all
rights be punished. Sometimes people like this turn to behaviors like sado-masochism,
or bondage-and-dominance in order to get the punishment that they want. Others
can't ask others to punish them, so they punish themselves with cutting.

A third theory is that cutting is a manifestation of a desire
to become physically unattractive. This is often true of girls who are
constantly bombarded with messages (overt and subtle) that they are beautiful
and therefore desirable. They naturally reason that if they make themselves
unattractive, no one will rape them because they will be undesirable. This chain
of reasoning can also lead to compulsive eating behaviors that leave the abuse
victim overweight and thus outside of what this society calls attractive.

Of course, every person is different, and there are many less
common theories as to why people are cutters. If a cutter doesn't fit any of the
above models, that doesn't mean their situation is fundamentally different or
less valid. Also, it is common for more than one of these thought patterns
acting in concert to produce some very complicated rationales for
self-mutilation. These desires can be quite strong, and often a cutter will not
know why s/he indulges in such behavior. (1)

Some articles on self-harm from the database at The Centre for Residential Child Care in
Glasgow contributed by Alan MacQuarrie:

Francis, Joy. Hurting only myself. Community Care, 1053, 2-8 Feb. 1995, 10
Disturbing evidence suggests practitioners are not equipped to meet the growing challenge of adolescent self-harm. Report on a Hackney initiative
to address the needs in this small and under-researched area.

Downey, Rachel, Young and alone . Community care, 1111, 14-20 Mar 1996, 23
The author goes behind the walls of Hull Prison to assess a radical new method of preventing self-harm and suicide among juveniles on remand.

Harrison, Diane , Scarred by pain . Community care,1135, 29 Aug-4 Sep 1996,17
A young woman inflicts pain on herself because she feels it is the only part
of her life over which she has any control. For that young woman and others
like her, self-harm is a way of expressing the unspeakable.

Teenage girls are more likely to harm themselves Professional Social Work, Sept 1996, 2
A study of admissions at the Warneford Hospital in Oxford has found that teenage girls are more likely to inflict harm on themselves than boys, and
that self-harm is rare under the age of 12.

C. Fulwiler, C. Forbes, S. L. Santangelo and M. Folstein, Self-mutilation
and suicide attempt: distinguishing features in prisoners. Journal of the
American Academy of Psychiatry and the Law 25(1): 69-77, 1997.

Nonlethal forms of self-injury are often discussed together
with suicide attempts as though they belonged on a continuum of self-harm.
Both types of self-injury are common in prisons, which have a predominantly
male population; however, most studies of nonlethal self-injury have been done
with female subjects. This exploratory study tested the hypothesis that
prisoners who injured themselves without intending to die would differ
clinically from prisoners who had attempted suicide. Inmates admitted to the
prison unit of a public hospital for treatment of self-inflicted wounds or who
had a history of previous self-injury were administered a standardized intake
protocol by the first author, which included asking about their intent at the
time they injured themselves. Patients were classified as self-mutilators or
suicide attempters on the basis of intent. Fifteen patients reported that they
had attempted to take their own lives, while 16 reported other reasons for
harming themselves. Suicide attempt was associated with adult affective
disorder 13/15 versus 2/16 mutilators); self-mutilation with a history of
childhood hyperactivity (12/16 versus 1/15 suicide attempters) and a mixed
dysthymia/anxiety syndrome that began in childhood or early adolescence
(9/16). Prison self-mutilators and suicide attempters had very different
clinical presentations and histories. The history of childhood hyperactivity
in self-mutilators deserves further study in both correctional and
noncorrectional populations.

Downey, Rachel; Young and alone; Community care, 1111, 14-20 Mar 1996, 23;
The author goes behind the walls of Hull Prison to assess a radical new method
of preventing self-harm and suicide among juveniles on remand.

Francis, Joy. ( 1995); Hurting only myself; Community Care, 1053, 2-8 Feb.
10;
Disturbing evidence suggests practitioners are not equipped to meet the growing
challenge of adolescent self-harm. Report on a Hackney initiative to address the
needs in this small and under-researched area.

Harrison, Diane; Scarred by pain; Community care,1135, 29 Aug-4 Sep 1996,17
A young woman inflicts pain on herself because she feels it is the only part of
her life over which she has any control. For that young woman and others like
her, self-harm is a way of expressing the unspeakable.

Professional Social Work. ( Sept 1996) No.2
A study of admissions at the Warneford Hospital in Oxford has found that teenage
girls are more likely to inflict harm on themselves than boys, and that
self-harm is rare under the age of 12.

Thompson, Audrey; Miah, Humerah .
(1999). Wounds that never heal .Community
care, 18-24. pp. 18-20
Most of us recoil from the idea of self-harm and those who inflict it on
themselves. Unfortunately, many health and care professionals have the same
reaction. Report and description of how it feels to be so desperate that you
harm yourself.

Wrate, R M; Suicidal tendencies; Scottish Child, November/December 1995,
8-11;
Analyses the reasons behind the increase in suicide and attempted suicide among
children and adolescents. Teenage girls are more likely to harm themselves

A well-known practitioner in the field is Tracy Alderman, Ph.D. (Licensed
Clinical Psychologist) San Diego, CA 92102. (619) 855-3293 DrTracyA@aol.com.
Author of The Scarred Soul: Understanding and ending self-inflicted violence,
a very wise and useful self-help book or people who self-harm.

You can read an interesting TRANSCRIPT
of an on-line question-and-answer conference.
___

SHOUT (Self-Harm overcome by understanding and tolerance)
Bi-monthly newsletter which aims to break down isolation and provide support —
includes articles, pen-pals/contacts, letters, poems, cartoons, book reviews, plus details of help lines, groups and resources. The mailing list is confidential and copies will be sent in a plain envelope.
To subscribe, contact SHOUT, PO Box 654, Bristol BS99 1XH UK
___
Internet Support
The Samaritans E-mail: jo@samaritans.org - Anonymous E-mail: samaritans@anon.twwells.com
The Samaritans are a non-religious charity that have been offering emotional support to the suicidal and despairing for over 40 years by phone, visit and letter. Callers are guaranteed absolute confidentiality and retain the right to make their own decisions including the decision to end their life. The service is now available via E-mail, run from Cheltenham, England, and can be reached from anywhere with Internet access. Trained volunteers read and reply to mail once a day, every day of the year.
___

S.A.F.E. in Canada
306-241 Simcoe Street, London, Ontario N6B 3L4
Provides therapy and support for self-injurers in Canada, teen programs, professional education, workshops (including one for family and friends), and literature. Cognitive-behavioral community-based model.

42nd Street - Suicide/Self-Harm worker
2nd Floor, Swan Buildings, 20 Swan Street, Manchester M4 5JW UK
0161 862 0170
42nd Street is a mental health service for Manchester young people aged fifteen to twenty-five who face wide and varied problems including self-harm and suicide. They offer a variety of individual support alongside a range of groups based at the resource and within the local community. They have initiated specific projects including a suicide/self-harm project which itself offers individual and group support to young people. They completed a research project on young people, self-harm and suicide and produced an excellent book based on their findings.
Bristol Crisis Service for Women
PO Box 654, Bristol BS99 1XH
0117 925 1119
Resources for women who self-harm, including several booklets and information sheets and help line service on Friday and Saturday nights between 9.00 p.m. and 12.30 a.m. They recently published "The Hurt Yourself Less" Workbook, written by people who self-injure, for people who self-injure.

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